Association between chlorpromazine therapy and necrotizing colitis

Abstract

A patient is described in whose case a relationship between chlorpromazine therapy [for mild schizophrenia] and necrotizing colitis is apparent. Consideration is given to the probable mechanisms linking the proposed cause and effect. The immediate practical implications of this case report seem to be that patients receiving chlorpromazine and other phenothiazine derivatives long term require continual evaluation of colonic function. Those in whom fecal retention develops should presumably undergo gentle disimpaction by mechanical means. One would imagine that cessation of chlorpromazine treatment is not a feasible proposition in the class of patients who take the drug regularly, and even if it were, it seems quite possible that its adverse effect would remain. Whether patients receiving chlorpromazine and related compounds should routinely be advised to adhere to a diet high in roughage and containing bran is not known.